ONUR BUĞDAYCI, MEHMET NİHAT KODALLI, FUAT DEDE, İsmet CENGİÇ, Derya TÜRELİ, Hilal AYDIN ALTAŞ, AHMET ASLAN

Comparison of diffusion weighted MRI parameters of mediastinal lymph nodes with PET/CT in lung cancer patients

ABSTRACTObjective: We have compared diffusion-weighted magneticresonance imaging (DW-MRI) properties of mediastinal lymphnodes in lung cancer patients with positron emission tomography/computed tomography (PET/CT) findings.Patients and Methods: Twenty-one consecutive untreatedpatients with lung cancer were included. DW-MRI was performedon a 1,5T scanner with b values of 50, 500 and 1000. AdditionalMR imaging was performed for anatomical correlation.Results: A total of 47 lymph nodes were analyzed. While nocorrelation was found between minimum apparent diffusioncoefficient (ADC) values (ADCmin) of lymph nodes and theirmaximum standardized uptake values (SUVmax) on PET/CT,ADCmin ratios of lymph nodes to main lesion (ADCmin Node/Lesion) (r = - 0.407; p = 0.005) and lymph node to cerebrospinalfluid (ADCmin Node/CSF) (r = - 0.364; p = 0.012) were correlatedwith SUVmax. Cutoff values for DW-MRI parameters weredetermined using ROC analysis. Six lymph nodes werehistopathologically examined. Both methods correctly identifiedone metastatic and two metastasis negative lymph nodes, whilestaging one lymph node with granulomatous change as metastasispositive. Two metastasis negative lymph nodes, reported assuspicious on PET/CT, were correctly staged on DW-MRI.Conclusion: Our findings indicate that DW-MRI could be atleast as valuable as PET/CT in mediastinal staging of patients withlung cancer.

Anahtar Kelimeler:

Difüzyon manyetik rezonans görüntüleme, Pozitron-emisyon tomografi/Bilgisayarlı tomografi, Akciğer tümörleri, Lenf nodları, Mediasten

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Objective: We have compared diffusion-weighted magnetic resonance imaging (DW-MRI) properties of mediastinal lymph nodes in lung cancer patients with positron emission tomography/computed tomography (PET/CT) findings. Patients and Methods: Twenty-one consecutive untreated patients with lung cancer were included. DW-MRI was performed on a 1,5T scanner with b values of 50, 500 and 1000. Additional MR imaging was performed for anatomical correlation. Results: A total of 47 lymph nodes were analyzed. While no correlation was found between minimum apparent diffusion coefficient (ADC) values (ADCmin) of lymph nodes and their maximum standardized uptake values (SUVmax) on PET/CT, ADCmin ratios of lymph nodes to main lesion (ADCmin Node/Lesion) (r = - 0.407; p = 0.005) and lymph node to cerebrospinal fluid (ADCmin Node/CSF) (r = - 0.364; p = 0.012) were correlated with SUVmax. Cutoff values for DW-MRI parameters were determined using ROC analysis. Six lymph nodes were histopathologically examined. Both methods correctly identified one metastatic and two metastasis negative lymph nodes, while staging one lymph node with granulomatous change as metastasis positive. Two metastasis negative lymph nodes, reported as suspicious on PET/CT, were correctly staged on DW-MRI. Conclusion: Our findings indicate that DW-MRI could be at least as valuable as PET/CT in mediastinal staging of patients with lung cancer.

Keywords:

Diffusion magnetic resonance imaging, Positronemission tomography/Computed tomography, Lung neoplasms, Lymph nodes, Mediastinum,

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